Virtual colonoscopies – the video game

Just kidding – but when I first heard the term “virtual colonoscopy” I thought of a video game in which you pretend to be exploring someone’s intestine. Virtual colonoscopy is actually a new diagnostic tool to detect colon cancer. The main difference between a virtual and a traditional (or optical) colonoscopy is that it eliminates having a camera venture into your intestine. Instead all of the imaging is done with a CAT scan or MRI to produce two- or three-dimensional images of the colon.

Sounds great, right? It is great for cancer surveillance, as long as your tumor is big enough to see on the scan. Virtual colonoscopies have been shown to be pretty accurate at identifying polyps and tumors that are larger than 10 mm, but if smaller they can be missed since the resolution of a virtual colonoscopy isn’t as high as a traditional one. In regard to diagnosing IBD, studies have shown a 60 to 70 percent success rate in identifying IBD by virtual colonoscopy. The disadvantage is that your doctor can’t take biopsies when you are being scanned as compared to doing it the good old fashioned way. In cases in which you would need a biopsy, you would end up doing both a virtual and then a regular colonoscopy; however, some hospitals can schedule for one after another to minimize inconvenience.

No, you wouldn’t have to drink barium-grossness just because it was a CAT scan.

No, it doesn’t eliminate all tubes in places you would prefer them not to be, but virtual colonoscopies only require a small tube to inflate the colon with air.

No, virtual colonoscopy does not require sedation and apparently you only feel the air pressure with no pain.

No, it’s not covered by most insurance plans yet. It looks like Medicare might start covering virtual colonoscopies for colon cancer screenings soon, which is the first step toward private insurance companies following suit.

I would bet that once the technology caught on, regular colonoscopies would probably still be the method of choice because of higher resolution images and the ability to biopsy. However with the remarkable improvements in imaging that have occurred in the last several years, it’s reasonable to think that the flexible camera might be obsolete in the not-too-distant future.

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